A medical ultrasound apparatus and associated methods of use is disclosed enabling a relatively non-invasive or minimally invasive method to treat skin or tissue. The apparatus is constructed from an ultrasound tip mechanically coupled to a shaft. The shaft is mechanical coupled to an ultrasound transducer driven by an ultrasound generator. The ultrasound tip possesses at least one radial surface, a cavity, or some other form of a hollowed out area, within at least one of the radial surfaces, and a non-metallic sheath covering portions of the tip so that only the sheath and not the tip would normally contact the patients skin. The disclosed method of treating spider, reticular or small varicose veins with the apparatus can be practiced by contacting the sheath with the patients epidermal skin layers and delivering ultrasonic energy released from the various surfaces of the vibrating tip to the skin and/or tissue through direct contact and/or with a coupling fluid focused from a cavity.